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Chalazion

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Synonyms of Chalazion

Disorder Subdivisions

General Discussion

Chalazion is a round, slowly emerging, localized swelling, in the form of a cyst located on the lower or upper eyelid. (Chalazion is the Greek word for "hailstone" which represents the size of the lump that makes up the cyst.) The usually painless, grainy (granulomatous) mass is due to inflammation, obstruction, and retained secretions of one of the glands that lubricates the edge of the eyelids. These glands secrete sebum, an oily, protective fluid. If one or more of the ducts that drain these glands is blocked, the sebum accumulates under the skin to form a cyst.

In rare cases, if the cyst is large, blurred vision may result due to pressure on the cornea, the front, clear portion of the eye through which light passes. In some affected individuals, chalazia may disappear spontaneously. However, in other cases, treatment may be required. Individuals with chronic inflammation of the eyelids (blepharitis) may be prone to recurrences.

Symptoms

Chalazion is a chronic inflammation of the meibomian gland, a gland of the eyelids that secretes an oily, protective fluid. It is characterized by an irritation and swelling of the eyelid. There may be a small, round, moveable swelling of the meibomian gland. The inflammation is usually painless unless it enlarges and causes an inflammation of the eyelids' membrane (conjunctiva). Chalazion tends to occur more often on he upper eyelid than on the lower eyelid.

Causes

The exact cause of chalazion is not known. It is thought to be caused by a blockage of the duct of the oil-producing meibomian gland. When oil cannot flow through the duct, it accumulates, resulting in a lump on the eyelid. Unlike styes, which form on the edge of the eyelids, chalazia are not the result of bacterial infection.

Affected Populations

Chalazion affects males and females in equal numbers.

Related Disorders

Symptoms of the following disorders can be similar to those of Chalazion. Comparisons may be useful for a differential diagnosis:

A Sty (External Hardeolum) is an acute, localized infection of one of the glands of the eyelid. It is a common condition characterized by pain, redness, and a small and round localized area of inflammation. A small yellow spot of pus will appear at the top of the swollen area. This will eventually rupture, draining the infection and relieving the pain. A sty is treated with hot compresses to promote drainage and antibiotic ointments.

Internal Hardeolum is a more severe and deeper infection of the meiboman gland. There is more localized pain, redness and swelling. On the inside of the eyelid a swelling occurs that may become abscessed. Rupture of the inflamed area is rare and repeat episodes are common. This disorder is treated with hot compresses and antibiotics. The drug Sulfacetemide may be used to prevent the infection from spreading to other areas of the body.

Blepharitis is an inflammation of the eyelids. Nonulcerative (squamous or seborrheic) blepharitis is characterized by itching, redness, swelling, loss of eye lashes, a discharge and irritation of the conjunctiva, excessive tearing, and sensitivity to light. It may be caused by an allergic reaction or an excess secretion of sebum of the face and scalp. With ulcerative blepharitis, a bacterial infection (usually staphylococcal) of the eyelids occurs causing pustules, crusts and ulcers of the eyelids. Treatment consists of topical antibiotics and warm compresses applied to the affected eye. Sulfacetemide-corticosteroid drops can be helpful in controlling further infections.

Tarsitis is an inflammation of the eyelids that may be caused by syphilis, tuberculosis or trachoma (an infectious disease of the conjunctiva and cornea). It is characterized by redness, swelling, tenderness, and pain in the eyelid. There may also be pus, crusts of the eyelash follicles and soft skin tumors (gummata) which may cause a thickening of the connective tissues of the eyelid (tarsus). This type of tumor may indicate a late stage of syphilis. Parenteral Penicillin G has proven effective in the treatment of nonallergic patients with Syphilis.

Standard Therapies

Chalazia will often subside after a few months. The application of hot compresses, and topical antibiotic ointments such as bacitracin and erythromycin, may be effective. If necessary, surgical removal can be done under local anesthesia, usually in an ophthalmologist's office. The healing process may require wearing an eye patch for about a day.

Investigational Therapies

Information on current clinical trials is posted on the Internet at www.clinicaltrials.gov. All studies receiving U.S. government funding, and some supported by private industry, are posted on this government web site.

For information about clinical trials being conducted at the NIH Clinical Center in Bethesda, MD, contact the NIH Patient Recruitment Office:

Tollfree: (800) 411-1222
TTY: (866) 411-1010
Email: prpl@cc.nih.gov

For information about clinical trials sponsored by private sources, contact:
www.centerwatch.com

Chalazion Resources

Organizations:

References

TEXTBOOKS
Beers MH, Berkow R., eds. The Merck Manual, 17th ed. Whitehouse Station, NJ: Merck Research Laboratories; 1999:710.

Berkow R., ed. The Merck Manual-Home Edition.2nd ed. Whitehouse Station, NJ: Merck Research Laboratories; 2003:1295.

JOURNAL ARTICLES
Dhaliwal U, Arora VK, Singh N, et al. Cytopathology of chalazia. Diagn Cytopathol. 2004;31.

D'hermies F, Fayet B, Meyer A. [Chalazion mimicking an eyelid tumor.] J Fr Ophthalmol. 2004;27:202-05. French.

Ozdal PC, Cordere F, Callejo S, et al. Accuracy of the clinical diagnosis of chalazion. Eye. 2004;18:135-38.

Shiramizu KM, Kreiger AE, McCannel CA. Severe visual loss caused by ocular perforation during chalazion removal. Am J Ophthalmol. 2004;137:204-05.

Ho SY, Lai JS. Subcutaneous steroid injection as treatment for chalazion: prospective case series. Hong Kong Med J. 2002;8:18-20.

Mustafa TA, Oriafage IH. Three methods of treatment of chalazia in children. Saudi Med J. 2001;22:968-72.

Jackson TL, Beun L. A prospective study of cost, patient satisfaction, and outcome of treatment of chalazion by medical and nursing staff. Br J Ophthalmol. 2000;84:782-85.

FROM THE INTERNET
Douglas RS. Medical Encyclopedia: Chalazion. MedlinePlus. Update Date: 12/22/2002. 2pp.
www.nlm.nih.gov/medlineplus/ency/article/001006.htm

Report last updated: 2008/04/25 00:00:00 GMT+0